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The Rational Clinical Examination
David L. Simel, Drummond Rennie
Splenomegaly
Alan N. Barkun, Steven A. Grover, Andrew Muir
Clinical Scenario


Topics Discussed: splenomegaly

Excerpt: "A 34-year-old man has complained of fatigue and abdominal pain. He presents to the emergency department with vague abdominal pain and fever. The medical history is also that of intermittent sweats and some weight loss. Your examination reveals diffuse adenopathy. Traube space is dull to percussion. You decide to try to palpate the spleen edge but, despite spending a few minutes examining the patient while he is supine and then while he is on his side, you decide that you cannot feel the spleen. According to your findings, how confident should you be that the spleen is not enlarged? ..."
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